|
PERMIT APPLICATION
<br /> BUILDING / MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION
<br /> #11111111P'10
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits
<br /> tt /' 4 Y b ,f✓S`��'✓ \ �`• K.., ", i $, „„, li ...�i :if.. .x g ..,\-a.;� .. 4�v �
<br /> PROJECT SITE ADDRESS:4621 WeStiew Dr PROPERTY TAX#:00605800003700
<br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
<br /> • ti • •.s' &tqI: 1I!:.0,4:1; Ct:IINIFOR ,. F - ,a, e •E ' r f , ,psi
<br /> OWNER NAME: Michael McCann TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET4621 Westview Dr
<br /> cry Everett STATE WA zip 98203
<br /> OWNER PHONE:425-879-7949 OWNER EMAIL:
<br /> CONTRACTOR NAME:WASHINGTON ENERGY SERVICES
<br /> CONTRACTOR ADDRESS: STREET 3909 196TH ST SW
<br /> cry LYNNWOOD STATE WA ZIP 98036
<br /> CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:vstephenson@washingtonenegy.com
<br /> washingtonenegy.Com
<br /> CONTRACTOR LICENSE#(REQUIRED):WASH I ES851NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773
<br /> PRIMARY CONTACT: 0 OWNER ECONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:206-378-6648
<br /> Vanessa Stephenson CONTACT EMAIL:vstephenson@washingtonenergy.com
<br /> k Ms a tMaki,AiiY,A,, ,P �" te�g
<br /> Existing Use of Building: Contract Price of Work:$6077
<br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other
<br /> Building Type: ✓❑SFR-Detached ❑SFR-Attached Ebuplex ❑Multi-Family-#of Units: ['Commercial ❑Industrial
<br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use
<br /> DESCRIPTION OF WORK: Installing a tankless water heater W/gas piping.
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> m CHANIIC*I PERMMrr ApPLuC�ATIO <.. . ,, 1. Pt.t,),;: ., G '. M .. Nf s tS.
<br /> =.�. .�.>,,c ..,,r...... .� ,,. ,.,...,.. a, :� �.. � ..,, ,-. ISR €�i ... � ...=� .. ...•
<br /> Type of Project: _New Addn lijAlteration _Repair Type of Project: _New _Addn UAlteration _Repair
<br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures
<br /> Fixtures Fixtures Fixtures Fixtures
<br /> NC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg)
<br /> Forced Air Systems Unit Heater Bathtub Urinal
<br /> 1 Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain
<br /> 1 Water Heater Refrigeration Shower Floor Drain
<br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap
<br /> Gas Range Ducting Dishwasher Roof Drains
<br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas
<br /> Range Hood Water Heater Other:
<br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other:
<br /> spRINKLEi /S Stt0.0 /:* �� ...
<br /> !Number of Heads
<br /> ACKNOWLEDGEMENT'I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with
<br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the
<br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made,
<br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.
<br /> t �Citity of Everett Official Use Only
<br /> PEN\`y`02 ...� DLq
<br /> Vanessa Stephenson !:15,,,,,°,,P,'17:,=="17.= 02/19/18 ` i v
<br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015)
<br />
|